gms | German Medical Science

Objective: The aim of this study is to investigate the role of intra-operative MR imaging in temporal lobe low-grade glioma (LGG) surgery and to report the surgical outcome in our series with regard to seizures, neurological defects, and quality of life.

Method: Patients with temporal lobe non-enhancing gliomas who presented with seizures in the course of their disease were enrolled in our prospective study. We non-randomly assigned patients to undergo intra-operative magnetic resonance imaging (iMRI)-guided surgery or conventional micro-surgery. Extent of resection (EOR) and surgical outcomes were compared between the two groups. The post-operative neurological deficits were recorded. And survey for the health related quality of life of the patients, were conducted and analyzed.

Results: Forty-one patients were analyzed in the iMRI group, and 14 were in the conventional group. Comparable EOR was achieved for the two groups (p = 0.634) although preoperative tumor volumes were significantly larger for the iMRI group. Seizure outcome tended to be better for the iMRI group (Engel class I achieved for 89.7 % (35/39) vs 75 % (9/12)), although this difference was not statistically different. Newly developed neurological deficits were observed in four patients (10.3 %) in iMRI group and two patients (16.7 %) in control group, respectively (p = 0.928). Free of seizures and neurological morbidity led to a return-to-work or return-to-school rate of 84.6 % (33/39) in iMRI group vs 75 % (9/12) in control group, respectively (p = 0.741).

Conclusions: Our study provided evidence that iMRI could be a safe and useful tool in temporal lobe LGG surgery. Optimal extent of resection contributed to favorable seizure outcome in our series with low morbidity rate, which led to a higher return-to-work rate. A larger cohort, randomized trial is needed to verify the real role of iMRI for the surgical management of temporal lobe LGGs.